Efficacy of individual computer-based auditory training for people with hearing loss: a systematic review of the evidence

Auditory training involves active listening to auditory stimuli and aims to improve performance in auditory tasks. As such, auditory training is a potential intervention for the management of people with hearing loss. Objective This systematic review (PROSPERO 2011: CRD42011001406) evaluated the published evidence-base for the efficacy of individual computer-based auditory training to improve speech intelligibility, cognition and communication abilities in adults with hearing loss, with or without hearing aids or cochlear implants. Methods A systematic search of eight databases and key journals identified 229 articles published since 1996, 13 of which met the inclusion criteria. Data were independently extracted and reviewed by the two authors. Study quality was assessed using ten pre-defined scientific and intervention-specific measures. Results Auditory training resulted in improved performance for trained tasks in 9/10 articles that reported on-task outcomes. Although significant generalisation of learning was shown to untrained measures of speech intelligibility (11/13 articles), cognition (1/1 articles) and self-reported hearing abilities (1/2 articles), improvements were small and not robust. Where reported, compliance with computer-based auditory training was high, and retention of learning was shown at post-training follow-ups. Published evidence was of very-low to moderate study quality. Conclusions Our findings demonstrate that published evidence for the efficacy of individual computer-based auditory training for adults with hearing loss is not robust and therefore cannot be reliably used to guide intervention at this time. We identify a need for high-quality evidence to further examine the efficacy of computer-based auditory training for people with hearing loss

How does auditory training work? Joined up thinking and listening

Auditory training aims to compensate for degradation in the auditory signal and is offered as an intervention to help alleviate the most common complaint in people with hearing loss, understanding speech in a background noise. Yet there remain many unanswered questions. This article reviews some of the key pieces of evidence that assess the evidence for whether, and how, auditory training benefits adults with hearing loss. The evidence supports that improvements occur on the trained task; however, transfer of that learning to generalized real-world benefit is much less robust. For more than a decade, there has been an increasing awareness of the role that cognition plays in listening. But more recently in the auditory training literature, there has been an increased focus on assessing how cognitive performance relevant for listening may improve with training. We argue that this is specifically the case for measures that index executive processes, such as monitoring, attention switching, and updating of working memory, all of which are required for successful listening and communication in challenging or adverse listening conditions. We propose combined auditory-cognitive training approaches, where training interventions develop cognition embedded within auditory tasks, which are most likely to offer generalized benefits to the real-world listening abilities of people with hearing loss

Assessing the benefits of auditory training to real-world listening: identifying appropriate and sensitive outcomes

Auditory training is an intervention that aims to improve auditory performance and help alleviate the difficulties associated with hearing loss. To be an effective intervention, any task-specific learning needs to transfer to functional benefits in real-world listening. The present study aimed to identify optimal outcome measures to assess the benefits of auditory training for people with hearing loss. Thirty existing hearing-aid users with mild-moderate sensorineural hearing loss trained on a phoneme discrimination in noise task. Complex measures of listening and cognition were assessed pre- and post-training. Functional benefits to everyday listening were examined using a dual-task of listening and memory and an adaptive two-competing talker task. There was significant on-task learning for the trained task (p < .001), and significant transfer of learning to improvements in competing speech (p < .05) and dual-task performance (p < .01). For the dual-task, improvements were shown for a challenging listening condition (0 dB SNR), with no improvements where the task was either too easy (in quiet) or too difficult (-4 dB SNR). Findings suggest that for listening abilities, the development of complex cognitive skills may be more important than the refinement of sensory processing. Outcome measures should be sensitive to the functional benefits of auditory training and set at an appropriately challenging level

Assessing the benefits of auditory training to real-world listening: identifying appropriate and sensitive outcomes

Auditory training is an intervention that aims to improve auditory performance and help alleviate the difficulties associated with hearing loss. To be an effective intervention, any task-specific learning needs to transfer to functional benefits in real-world listening. The present study aimed to identify optimal outcome measures to assess the benefits of auditory training for people with hearing loss. Thirty existing hearing-aid users with mild-moderate sensorineural hearing loss trained on a phoneme discrimination in noise task. Complex measures of listening and cognition were assessed pre- and post-training. Functional benefits to everyday listening were examined using a dual-task of listening and memory and an adaptive two-competing talker task. There was significant on-task learning for the trained task (p < .001), and significant transfer of learning to improvements in competing speech (p < .05) and dual-task performance (p < .01). For the dual-task, improvements were shown for a challenging listening condition (0 dB SNR), with no improvements where the task was either too easy (in quiet) or too difficult (-4 dB SNR). Findings suggest that for listening abilities, the development of complex cognitive skills may be more important than the refinement of sensory processing. Outcome measures should be sensitive to the functional benefits of auditory training and set at an appropriately challenging level

Working memory training for adult hearing aid users: study protocol for a double-blind randomized active controlled trial

Background: One in ten people aged between 55 to 74 years have a significant hearing impairment in their better hearing ear (as defined by audiometric hearing thresholds). However, it is becoming increasingly clear that the challenges faced by older listeners cannot be explained by the audiogram alone. The ability for people with hearing loss to use cognition to support speech perception allows for compensation of the degraded auditory input. This in turn offers promise for new cognitive-based rehabilitative interventions. Working memory is known to be highly associated with language comprehension and recent evidence has shown significant generalization of learning from trained working memory tasks to improvements in sentence-repetition skills of children with severe to profound hearing loss. This evidence offers support for further investigation into the potential benefits of working memory training to improve speech perception abilities in other hearing impaired populations. Methods/Design: This is a double-blind randomized active controlled trial aiming to assess whether a program of working memory training results in improvements in untrained measures of cognition, speech perception and self-reported hearing abilities in adult hearing aid users (aged 50 to 74 years) with mild-to-moderate hearing loss, compared with an active control group who receive a placebo version of the working memory training program. Discussion: The present study aims to generate high-quality preliminary evidence for the efficacy of working memory training for adults with mild-to-moderate sensorineural hearing loss who are existing hearing aid users. This trial addresses a number of gaps in the published literature assessing training interventions for people with hearing loss, and in the general literature surrounding working memory training, such as the inclusion of an active control group, participant and tester blinding, and increased transparency in reporting

P-R-E-V Teaching Predictions and Concepts Simultaneously

A question of concern among content area teachers is-Will making predictions prior to text reading increase a student\u27s comprehension of material read

Self-efficacy, communication difficulties and readiness predict outcomes in new hearing aid users

Self-efficacy, communication difficulties and readiness predict outcomes in new hearing aid user

Evaluation of the psychometric properties of the Social Isolation Measure (SIM) in adults with hearing loss

This study aimed to evaluate the psychometric properties of a brief, hearing-specific outcome measure: the Social Isolation Measure (SIM). In Phase 1, adults with hearing loss were invited to complete an online survey that contained the SIM, a hearing-specific participation questionnaire, a generic activity and participation questionnaire, and a generic loneliness questionnaire. In Phase 2, the participants were asked to complete the SIM for a second time 2-3 weeks following Phase 1. One hundred and sixteen adults with hearing loss completed Phase 1. Ninety-five participants also completed Phase 2. Twenty-nine participants were excluded from the Phase 2 data analysis because they reported that their hearing had changed since Phase 1 or because they completed Phase 2 outside of the 2-3 week interval following Phase 1. In support of its construct validity, the SIM had a strong correlation with the hearing-specific questionnaire and moderate correlations with the generic questionnaires. The findings also supported the internal consistency, interpretability, and test-retest reliability of the SIM. In conclusion, the SIM was found to have strong psychometric properties. It could serve as a brief measure of perceived social isolation in research or clinical practice

The unavailability of nature : anxieties of place and Pākehā identity in the writings of Pip Adam, Robin Hyde, and Blanche Baughan : a thesis presented in partial fulfilment of the requirements for the degree of Master of Arts in English at Massey University, Manawatū, New Zealand

This thesis argues that the idea of nature is never fully available to Pākehā literature, and that is manifested as various kinds of anxiety and uncanny returns. It begins in the twenty first century with Pip Adam’s The New Animals (2017), which considers the effects of a consumerist society on not only the ecological state of the planet, but also the human psyche. From there it moves back to consider Robyn Hyde’s The Godwits Fly (1938), which offers a vision of Pākehā society as shaped by outdated sociological rules inherited from an idea of England, trapping both humans and animals in early twentieth century city streets with an existential awareness that native New Zealand, already, can no longer be located. Finally, Blanche Baughan’s “A Bush Section” (1908) is approached not simply as a vindication of the settler assault on nature, nor as a justification of bush clearing as a means to an end, but as an antecedent of both The Godwits Fly and The New Animals in its evocation of a sense of deep anxiety with regards to the preoccupation of imagining Pākehā belonging in relation to nature

Characteristics of auditory processing disorder in primary school-aged children

The aims of this research were to identify and compare auditory processing, speech intelligibility, cognitive, listening, language and communication abilities in (i) typically developing, mainstream school (MS) children (n = 122) for direct comparison with (ii) children presenting to clinical services with auditory processing disorder (APD) (n = 19) or specific language impairment (SLI) (n = 22), and in (iii) a large population sample (n = 1469) who were categorised by their functional listening and communication abilities according to parental report rather than clinical diagnosis. All had normal hearing sensitivity. The clinically referred APD and SLI groups shared many behavioural characteristics across the broad range of measures. Both clinical groups significantly underperformed compared to the MS children, and the APD and SLI groups were virtually indistinguishable. This suggests diagnosis was based more on the referral route than on the actual differences. There was little association of auditory processing deficits with listening or language problems in either the clinical or the population sample after accounting for nonverbal IQ. The only exceptions were backward masking and frequency discrimination, the AP tests with the highest cognitive load. Poor general cognitive abilities were evident in those children with listening or language problems. These results suggest that top-down processing influences listening and language more than bottom-up sensory processing. It is argued that the term APD is a misnomer and should be renamed listening impairment. The co-occurrence of APD, or listening impairment, with both language impairment and autistic behaviours in the clinical and population samples suggests that APD is not a discrete and categorical disorder. Instead, APD as it is currently conceptualised, is dimensional, positioned more towards the language than the autistic extreme. Children with listening impairment who attend Audiology or ENT clinics should be screened for functional everyday measures of language and autistic behaviours to ensure appropriate onward referrals